Gottlieb H J, Koller R, Alperson B L
Arch Phys Med Rehabil. 1982 Oct;63(10):458-61.
The outcome of the management of chronic low back pain in 42 men and 36 women by a comprehensive rehabilitation program consisting of biofeedback training, counseling in self-control techniques, self-regulated medication reduction, physical therapy, vocational rehabilitation services and education conducted in a therapeutic milieu was examined at 6 months and 12 months after discharge. The mean age of the subjects was 43.4 years: the mean highest school grade completed, 12.6; and the mean full scale WAIS IQ, 106.7. On admission 72 were unemployed and had been disabled and unemployed for a median time for 3 years. Almost two-thirds were involved in litigation. Thirty-three were working or accepted for employment t 6 months after discharge and 35 at 12 months (p less than 0.001). Success rates are higher when only those who stayed in the program for more than 4 weeks are considered. The employed patients rated their pain lower, used less medication and relied less on attention from physicians. They did not seem to differ in their use of relaxation skills or exercise. A similar study has been initiated of patients randomly assigned to treatment and waiting list control groups.
通过一项综合康复计划对42名男性和36名女性的慢性下背痛进行管理,该计划包括生物反馈训练、自我控制技术咨询、自我调节药物减量、物理治疗、职业康复服务以及在治疗环境中开展的教育,在出院后6个月和12个月时对结果进行了检查。受试者的平均年龄为43.4岁:平均完成的最高学历为12.6级;韦氏成人智力量表(WAIS)全量表智商平均为106.7。入院时,72人失业,已残疾且失业的中位时间为3年。近三分之二的人卷入诉讼。33人在出院后6个月时恢复工作或被录用,35人在12个月时恢复工作或被录用(p<0.001)。如果只考虑那些参加该计划超过4周的人,成功率会更高。就业患者对疼痛的评分更低,用药更少,对医生关注的依赖也更少。他们在使用放松技巧或锻炼方面似乎没有差异。已针对随机分配到治疗组和等候名单对照组的患者启动了一项类似研究。